Use of Vibrio cholerae vaccine in an outbreak in Guinea

Francisco J. Luquero, Lise Grout, Iza Ciglenecki, Keita Sakoba, Bala Traore, Melat Heile, Alpha Amadou Diallo, Christian Itama, Anne Laure Page, Marie Laure Quilici, Martin A. Mengel, Jose Maria Eiros, Micaela Serafini, Dominique Legros, Rebecca F. Grais

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The use of vaccines to prevent and control cholera is currently under debate. Shanchol is one of the two oral cholera vaccines prequalified by the World Health Organization; however, its effectiveness under field conditions and the protection it confers in the first months after administration remain unknown. The main objective of this study was to estimate the short-term effectiveness of two doses of Shanchol used as a part of the integrated response to a cholera outbreak in Africa. METHODS: We conducted a matched case-control study in Guinea between May 20 and October 19, 2012. Suspected cholera cases were confirmed by means of a rapid test, and controls were selected among neighbors of the same age and sex as the case patients. The odds of vaccination were compared between case patients and controls in bivariate and adjusted conditional logistic-regression models. Vaccine effectiveness was calculated as (1 - odds ratio) x 100. RESULTS: Between June 8 and October 19, 2012, we enrolled 40 case patients and 160 controls in the study for the primary analysis. After adjustment for potentially confounding variables, vaccination with two complete doses was associated with significant protection against cholera (effectiveness, 86.6%; 95% confidence interval, 56.7 to 95.8; P = 0.001). CONCLUSIONS: In this study, Shanchol was effective when used in response to a cholera outbreak in Guinea. This study provides evidence supporting the addition of vaccination as part of the response to an outbreak. It also supports the ongoing efforts to establish a cholera vaccine stockpile for emergency use, which would enhance outbreak prevention and control strategies.

Original languageEnglish (US)
Pages (from-to)2111-2120
Number of pages10
JournalNew England Journal of Medicine
Volume370
Issue number22
DOIs
StatePublished - 2014
Externally publishedYes

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Cholera Vaccines
Guinea
Vibrio cholerae
Cholera
Disease Outbreaks
Vaccination
Vaccines
Logistic Models
Confounding Factors (Epidemiology)
Case-Control Studies
Emergencies
Odds Ratio
Confidence Intervals
shanchol

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Luquero, F. J., Grout, L., Ciglenecki, I., Sakoba, K., Traore, B., Heile, M., ... Grais, R. F. (2014). Use of Vibrio cholerae vaccine in an outbreak in Guinea. New England Journal of Medicine, 370(22), 2111-2120. https://doi.org/10.1056/NEJMoa1312680

Use of Vibrio cholerae vaccine in an outbreak in Guinea. / Luquero, Francisco J.; Grout, Lise; Ciglenecki, Iza; Sakoba, Keita; Traore, Bala; Heile, Melat; Diallo, Alpha Amadou; Itama, Christian; Page, Anne Laure; Quilici, Marie Laure; Mengel, Martin A.; Eiros, Jose Maria; Serafini, Micaela; Legros, Dominique; Grais, Rebecca F.

In: New England Journal of Medicine, Vol. 370, No. 22, 2014, p. 2111-2120.

Research output: Contribution to journalArticle

Luquero, FJ, Grout, L, Ciglenecki, I, Sakoba, K, Traore, B, Heile, M, Diallo, AA, Itama, C, Page, AL, Quilici, ML, Mengel, MA, Eiros, JM, Serafini, M, Legros, D & Grais, RF 2014, 'Use of Vibrio cholerae vaccine in an outbreak in Guinea', New England Journal of Medicine, vol. 370, no. 22, pp. 2111-2120. https://doi.org/10.1056/NEJMoa1312680
Luquero FJ, Grout L, Ciglenecki I, Sakoba K, Traore B, Heile M et al. Use of Vibrio cholerae vaccine in an outbreak in Guinea. New England Journal of Medicine. 2014;370(22):2111-2120. https://doi.org/10.1056/NEJMoa1312680
Luquero, Francisco J. ; Grout, Lise ; Ciglenecki, Iza ; Sakoba, Keita ; Traore, Bala ; Heile, Melat ; Diallo, Alpha Amadou ; Itama, Christian ; Page, Anne Laure ; Quilici, Marie Laure ; Mengel, Martin A. ; Eiros, Jose Maria ; Serafini, Micaela ; Legros, Dominique ; Grais, Rebecca F. / Use of Vibrio cholerae vaccine in an outbreak in Guinea. In: New England Journal of Medicine. 2014 ; Vol. 370, No. 22. pp. 2111-2120.
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abstract = "BACKGROUND: The use of vaccines to prevent and control cholera is currently under debate. Shanchol is one of the two oral cholera vaccines prequalified by the World Health Organization; however, its effectiveness under field conditions and the protection it confers in the first months after administration remain unknown. The main objective of this study was to estimate the short-term effectiveness of two doses of Shanchol used as a part of the integrated response to a cholera outbreak in Africa. METHODS: We conducted a matched case-control study in Guinea between May 20 and October 19, 2012. Suspected cholera cases were confirmed by means of a rapid test, and controls were selected among neighbors of the same age and sex as the case patients. The odds of vaccination were compared between case patients and controls in bivariate and adjusted conditional logistic-regression models. Vaccine effectiveness was calculated as (1 - odds ratio) x 100. RESULTS: Between June 8 and October 19, 2012, we enrolled 40 case patients and 160 controls in the study for the primary analysis. After adjustment for potentially confounding variables, vaccination with two complete doses was associated with significant protection against cholera (effectiveness, 86.6{\%}; 95{\%} confidence interval, 56.7 to 95.8; P = 0.001). CONCLUSIONS: In this study, Shanchol was effective when used in response to a cholera outbreak in Guinea. This study provides evidence supporting the addition of vaccination as part of the response to an outbreak. It also supports the ongoing efforts to establish a cholera vaccine stockpile for emergency use, which would enhance outbreak prevention and control strategies.",
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AU - Traore, Bala

AU - Heile, Melat

AU - Diallo, Alpha Amadou

AU - Itama, Christian

AU - Page, Anne Laure

AU - Quilici, Marie Laure

AU - Mengel, Martin A.

AU - Eiros, Jose Maria

AU - Serafini, Micaela

AU - Legros, Dominique

AU - Grais, Rebecca F.

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N2 - BACKGROUND: The use of vaccines to prevent and control cholera is currently under debate. Shanchol is one of the two oral cholera vaccines prequalified by the World Health Organization; however, its effectiveness under field conditions and the protection it confers in the first months after administration remain unknown. The main objective of this study was to estimate the short-term effectiveness of two doses of Shanchol used as a part of the integrated response to a cholera outbreak in Africa. METHODS: We conducted a matched case-control study in Guinea between May 20 and October 19, 2012. Suspected cholera cases were confirmed by means of a rapid test, and controls were selected among neighbors of the same age and sex as the case patients. The odds of vaccination were compared between case patients and controls in bivariate and adjusted conditional logistic-regression models. Vaccine effectiveness was calculated as (1 - odds ratio) x 100. RESULTS: Between June 8 and October 19, 2012, we enrolled 40 case patients and 160 controls in the study for the primary analysis. After adjustment for potentially confounding variables, vaccination with two complete doses was associated with significant protection against cholera (effectiveness, 86.6%; 95% confidence interval, 56.7 to 95.8; P = 0.001). CONCLUSIONS: In this study, Shanchol was effective when used in response to a cholera outbreak in Guinea. This study provides evidence supporting the addition of vaccination as part of the response to an outbreak. It also supports the ongoing efforts to establish a cholera vaccine stockpile for emergency use, which would enhance outbreak prevention and control strategies.

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